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    Health economic burden that wounds impose on the National Health Service in the UK

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    guest_et_al_2015.pdf (840.2Kb)
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    Publication date
    2015-12-07
    Author
    Guest, J.F.
    Ayoub, N.
    McIlwraith, T.
    Uchegbu, I.
    Gerrish, A.
    Weidlich, D.
    Vowden, Kath
    Vowden, Peter
    Keyword
    Health economics
    ; Wound management
    Wound care; NHS; UK; Wound management; National Health Service; Costs
    Rights
    (c) 2015 The Authors. This is an Open Access article distributed under the Creative Commons CC-BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/)
    Peer-Reviewed
    Yes
    
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    Abstract
    OBJECTIVE: To estimate the prevalence of wounds managed by the UK's National Health Service (NHS) in 2012/2013 and the annual levels of healthcare resource use attributable to their management and corresponding costs. METHODS: This was a retrospective cohort analysis of the records of patients in The Health Improvement Network (THIN) Database. Records of 1000 adult patients who had a wound in 2012/2013 (cases) were randomly selected and matched with 1000 patients with no history of a wound (controls). Patients' characteristics, wound-related health outcomes and all healthcare resource use were quantified and the total NHS cost of patient management was estimated at 2013/2014 prices. RESULTS: Patients' mean age was 69.0 years and 45% were male. 76% of patients presented with a new wound in the study year and 61% of wounds healed during the study year. Nutritional deficiency (OR 0.53; p<0.001) and diabetes (OR 0.65; p<0.001) were independent risk factors for non-healing. There were an estimated 2.2 million wounds managed by the NHS in 2012/2013. Annual levels of resource use attributable to managing these wounds and associated comorbidities included 18.6 million practice nurse visits, 10.9 million community nurse visits, 7.7 million GP visits and 3.4 million hospital outpatient visits. The annual NHS cost of managing these wounds and associated comorbidities was pound5.3 billion. This was reduced to between pound5.1 and pound4.5 billion after adjusting for comorbidities. CONCLUSIONS: Real world evidence highlights wound management is predominantly a nurse-led discipline. Approximately 30% of wounds lacked a differential diagnosis, indicative of practical difficulties experienced by non-specialist clinicians. Wounds impose a substantial health economic burden on the UK's NHS, comparable to that of managing obesity ( pound5.0 billion). Clinical and economic benefits could accrue from improved systems of care and an increased awareness of the impact that wounds impose on patients and the NHS.
    URI
    http://hdl.handle.net/10454/9286
    Version
    Published version
    Citation
    Guest JF, Ayoub N, McIlwraith T et al (2015) Health economic burden that wounds impose on the National Health Service in the UK. BMJ Open. 5(12): e009283.
    Link to publisher’s version
    http://dx.doi.org/10.1136/bmjopen-2015-009283
    Type
    Article
    Collections
    Health Studies Publications

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